The Pancreas + x

Question 1

• What the major exocrine‐related and endocrine‐related functions of the pancreas are

Answer 1

o Exocrine: Acinar and epithelial cells secrete pancreatic enzymes.
o Endocrine: Cells of the islets secrete insulin and glucagon into bloodstream.

Question 2

• What the major constituents of pancreatic juice released into the small intestine are

Answer 2

o Pancreatic enzymes:
 Fats:
• Pancreatic Lipase: Breaks down triglycerides in FFA.
 Carbohydrates:
• Pancreatic Alpha-Amylase: Starches into glucose.
 Protein – Bulk is inactive until it reaches S.I
• Proteolytic: Breaks certain Proteins.
• Proteases: Breaks large proteins
• Peptidase: Breaks small peptides into A.A

Question 3

• What the importance of bicarbonate secretion is in pancreatic juices:

Answer 3

o Secretin is stimulates Bicarbonate secretion in pancreatic ducts into duodenum when S cells detect HCL.

Question 4

• What the major pancreatic defect in people with cystic fibrosis is, and what nutritional strategies can help to treat this defect?

Answer 4

o Lower levels of digestive enzymes. (Duodenum is more acidic)
 Enzyme therapy replacement.
• To be taken at complete meals.
o Have nutritious diet.
 High energy, high fat. (35/40% of intake)
o High salt intake.
o Aim for intakes of (fat-sol) and mineral intake.
o Possibly use appetite stimulants.

Question 5

• What the major hormones released from alpha, beta and delta cells of the pancreas are

Answer 5

o Islets of Langerhans contains 3 major cells.
 Alpha – Secretes Glucagon that stimulates Glucose production. (15-20%)
 Beta- Secrets Insulin that decreases glucose level. (70-80%)
 Delta – Secrete Somatostatin that inhibit Alpha & Beta Cells.
• Released by parential cells in stomach.

Question 6

• What the metabolic effects of high and low levels of glucagon are in the liver

Answer 6

 Peptide (29 AA)
 Primary function is to prevent HYPOGLYCEMIA by increasing production of glucose in liver (PRIMARY) & kidneys
o High glucagon = Fasted state
 Acts on liver to breakdown glycogen stores in liver.
 Inhibits glycolysis.
 Increases gluconeogenesis from A.A & lipolysis.
o Low glucagon = Fed state

Question 7

• What fundamental defects exist in type I vs. type II diabetes

Answer 7

	Hypoglycemia is key indicator. 
o	Type 1: Islets of Langerhans are destroyed by autoimmune attack. 
	No /low insulin is released from pancreas. 
	Body keeps producing glucose through:
•	Glycogenoylsis
•	Gluconeogensis 
•	Ketogenesis 
o	Type 2: Insulin resistance.
	Normal response to insulin is dulled. 
	Lifestyle related.

Question 8

• What are the four parts of the pancreas?

Answer 8

o Head, Neck, Body & Tail

Question 9

• What is the main duct of the pancreas?

Answer 9

o Wirsung. Which runs entire length of pancreas.

Question 10

• What is Cystic fibrosis?

Answer 10

o Excessive production of mucus in lungs. Detected by sweat test. (Increase Na & Cl production. S.R has increased
o Results in maldigestion & malabsorption. (lower levels of digestive enzymes)

Question 11

• What are some of the dietary/biological issues of C.F?

Answer 11

o Patients have INCREASED RMR.
 Require more KJ to maintain basic physiological function.
o Difficult consuming energy
o Malnutrition/absorption of nutrients.
o Must be healthy weight. (Less than 25 BMI)

Question 12

• What is the structure of insulin? - What is the structure of insulin?

Answer 12

o 3 domain sturcutures. B-C-A
 An amino-terminal B chain.
 A carboxy-terminal A chain
 A connecting peptide = C